Ultimate Guide To DICOM
DICOM is a standard for digital medical images and information. It defines a file format and a network protocol for interoperability among devices and systems. DICOM covers different imaging modalities, such as CT, MRI, ultrasound, and X-ray. DICOM enables the exchange and analysis of medical images. DICOM has been around since 1985 and there are billions of DICOM compliant images in the world today.
Why do we need something like DICOM?
Let's walkthrough the below example to understand the complexities of a hospital workflow.
Consider a hospital named Sunview General Hospital which has many departments, and many patients visit this hospital every day.
Grace, who needs a follow up xray of her for fractured wrist, decides to visit Sunview General Hospital. When she enters the hospital, she goes to the admissions department and meets Molly the receptionist. Molly takes down Grace’s basic information on the Hospital Information System and directs her to the Radiology department for a xray.
Grace meets Xavier in the Radiology Department who collects Grace’s information schedules an appointment on the Radiology Information System (RIS). Grace is then sent to the waiting room and subsequently called into the Xray room 2 for a Xray.
Inside Xray room 2, a technologist Marie meets Gace and confirms her details on the Digital Xray Scanning device. Marie then positions Grace’s hand and performs a Xray. Marie checks the Xray images on the device and sends it to the Hospital Review Workstation. Grace returns to the waiting room awaiting the results and the film containing here image.
Grace’s xray images are seen by a Radiologist on a Review Workstation and a report is generated. At the same time, Grace’s xray images are sent to hospital Picture Archiving and Communications System for long term storage.
Further, the Xray images are sent to the Radiology department’s Xray printer where it is printed on a xray film and provided to Grace.
From the above story, you can observe that multiple “Systems” must communicate together for a successful xray examination. Examples of these systems communication to each other are, the RIS where Grace’s appointment was scheduled and the Xray Scanner device where Grace’s appointment was already present.
For these systems to communicate with each other they need a common language — DICOM.
Introduction to DICOM
Broadly DICOM can be dived into 2 aspects:
- DICOM Network Protocol
- DICOM File Format
DICOM Network Protocol defines how two systems should communicate and collaborate with each other. For example, DICOM defines how one system can send a xray image to another system for storage.
DICOM File Format defines how an image will be stored. This includes the metadata like patient name and the pixel data. We will see further in the guide that this format is not just limited to images.
This guide is split into various sections:
Part 1 — Introduction to DICOM (this section)
Part 2 — Introduction to Network Protocol
Part 3 — DICOM Network Services
Part 4 — Introduction to DICOM File Encoding
I hope this guide enhances your understanding of DICOM. Feel free to share your thoughts if there are specific sections of DICOM on which you would like more information.
I intend to make this the last guide you will ever need for DICOM.I will be publishing remaining parts soon.
